MSCT双期增强对胰腺实性假乳头状瘤的诊断价值

Value of MSCT with dual-phase enhanced in the diagnosis of solid pseudopapillary tumor of pancreas

目的 探讨胰腺实性假乳头状瘤（SPTP）的CT影像学特征及双期增强扫描对该病的诊断价值.方法 回顾性分析38例经手术病理证实的SPTP患者的CT影像资料,20例行双期增强扫描,18例行三期增强扫描;观察肿瘤CT影像学特点、实性成分强化程度及峰值.结果38例SPTP患者均为单发,位于胰头部14例,胰颈部4例,胰体部8例,胰尾部7例,体尾交界区4例,头颈交界区1例.病灶大小2.4~7.8 cm.实性为主12例,囊实相间24例,囊性为主2例.增强呈不均匀强化,实性成分呈轻中度强化,峰值位于门静脉期或延迟期.结论 SPTP的CT影像学表现具有一定的特征性,结合临床特点可在术前作出准确的诊断;MSCT双期增强对于本病的诊断准确率与三期增强无差异,且双期增强可减少患者接受的有效辐射剂量,提高检查效率,值得推广.

Objective To explore the CT imaging features of solid pseudo- papillary tumor of pancreas （SPTP） and the diagnostic value of dual-enhanced scanning in SPTP. Methods CT imaging data of 38 cases with SPTP confirmed by surgical pathology were retrospectively analyzed, among whom there were 20 cases who had underwent dual-phases enhanced scanning and 18 cases who had underwent three-phases enhanced, the CT imaging features of the tumors,enhancement degree and the enhancement peak phase of tumors′solid composition were observed. Results All the tumors were single.Tumor located in the head of pancreas in 14 cases, in the neck in 4 cases,in the body in 8 cases, in the tail in 7 cases, in the body-tail of border in 4 cases,and 1 case in the head-neck of border.The size of tumors was 2.4＋7.8 cm;tumor of 12 cases was solid mainly,of 24 cases was solid and cystic,and of 2 cases was cystic mainly. Enhancement was uneven. The solid composition showed mild-to-moderate reinforcement, and the enhanced peak stage was in portal vein phase or delay phase.Conclusions There are some characteristics in CT imaging findings of SPTP, CT imaging combined with clinical characteristics can make an accurate diagnosis before operation. The diagnosis accuracy of SPTP with MSCT through dual- phases enhancement scaning and the three- phases enhancement shows no difference,and the former scaning technology can reduce the received effective radiation dose of patients and improve the efficiency of examining.It is worth of promoting.